Characteristics of cerebral glucose metabolism in patients with cognitive impairment in multiple system atrophy.

IF 4.5 2区医学 Q2 GERIATRICS & GERONTOLOGY Frontiers in Aging Neuroscience Pub Date : 2025-03-05 eCollection Date: 2025-01-01 DOI:10.3389/fnagi.2025.1520515

Bin Chen, Lingchao Li, Lin Bai, Min Zhao, Ying Chang, Shi Gao

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Abstract

Objective: We aimed to conduct ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) to investigate the metabolic changes in brain regions associated with cognitive decline in patients with multiple system atrophy (MSA) and to assess the diagnostic efficacy of ¹⁸F-FDG PET imaging for evaluating the cognitive status of MSA patients.

Methods: This study included 44 MSA patients (MSA group) and 30 healthy controls (HC group) who underwent brain ¹⁸F-FDG PET imaging. All patients were subjected to the Mini-Mental State Examination and categorized into the MSA with normal cognition (MSA-NC) and MSA with cognitive impairment (MSA-CI) groups. Statistical parametric mapping (version 12) was used to analyze PET images and compare the differences in brain metabolism between the MSA and HC groups. The PET images of MSA-CI and MSA-NC patients were compared to analyze the metabolic characteristics, and the regional cerebral metabolic rate of glucose (rCMRglc) was calculated for different brain regions. Receiver operating characteristic (ROC) curves were used to analyze the ability of the rCMRglc of different brain regions to assess the cognitive status of MSA patients.

Results: Compared with the HC group, the MSA group showed diffuse reductions in glucose metabolism in the cerebellar regions, decreased metabolism in specific areas of the left inferior parietal lobule, right putamen, and left middle temporal gyrus, and increased metabolism in the left postcentral gyrus, right postcentral gyrus, left precuneus. Compared with the MSA-NC group, the MSA-CI group exhibited decreased metabolism in the right superior frontal gyrus and right superior parietal lobule. The rCMRglc value of the right superior frontal gyrus (Montreal Neurological Institute coordinates: 18, -6, 70) showed better diagnostic efficacy for identifying MSA-CI, with an area under the ROC curve of 0.829 (95%CI = 0.696-0.963), sensitivity of 84.6% (95%CI = 66.5-93.9%), and specificity of 83.3% (95%CI = 60.8-94.2%).

Conclusion: Compared with MSA-NC patients, the MSA-CI patients show decreased metabolism in the right superior frontal gyrus and right superior parietal lobule. The rCMRglc value of the right superior frontal gyrus may be a potential molecular imaging biomarker for diagnosing MSA-CI.

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多系统萎缩认知障碍患者脑糖代谢特征。

目的：通过18f -氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描（PET）研究多系统萎缩（MSA）患者认知能力下降相关脑区代谢变化，评价18F-FDG PET成像对MSA患者认知状态的诊断价值。方法：选取44例MSA患者（MSA组）和30例健康对照（HC组）进行脑18F-FDG PET显像。所有患者均接受简易精神状态检查，并将其分为认知正常的MSA组（MSA- nc）和认知障碍的MSA组（MSA- ci）。采用统计参数映射（version 12）分析PET图像，比较MSA组和HC组脑代谢的差异。比较MSA-CI和MSA-NC患者的PET图像，分析代谢特征，计算不同脑区葡萄糖区域脑代谢率（rCMRglc）。采用受试者工作特征（ROC）曲线分析不同脑区rCMRglc评估MSA患者认知状态的能力。结果：与HC组比较，MSA组小脑区域葡萄糖代谢弥漫性降低，左侧顶叶下小叶、右侧壳核、左侧颞中回特定区域代谢降低，左侧中央后回、右侧中央后回、左侧楔前叶代谢增加。与MSA-NC组相比，MSA-CI组右侧额上回和右侧顶叶上小叶代谢降低。右侧额上回rCMRglc值（Montreal Neurological Institute坐标：18，- 6,70）对MSA-CI的诊断效果较好，ROC曲线下面积为0.829 (95%CI = 0.696-0.963)，敏感性为84.6% (95%CI = 66.5-93.9%)，特异性为83.3% （95%CI = 60.8-94.2%）。结论：与MSA-NC患者相比，MSA-CI患者右侧额上回和右侧顶叶上小叶代谢降低。右侧额上回的rCMRglc值可能是诊断MSA-CI的潜在分子成像生物标志物。

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来源期刊

Frontiers in Aging Neuroscience GERIATRICS & GERONTOLOGY-NEUROSCIENCES

CiteScore

6.30

自引率

8.30%

发文量

1426

期刊介绍： Frontiers in Aging Neuroscience is a leading journal in its field, publishing rigorously peer-reviewed research that advances our understanding of the mechanisms of Central Nervous System aging and age-related neural diseases. Specialty Chief Editor Thomas Wisniewski at the New York University School of Medicine is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.